• Journal of Institute of Control, Robotics and Systems
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• v.22 no.8
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• pp.615-618
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• 2016

This paper proposes a method to estimate vertical interaction force to the end of the surgical instrument by measuring reaction force at the part supporting the trocar. Relation between the force to the trocar and the interaction force is derived using the beam theory. The vertical interaction force is modeled as a function of the reaction force to the trocar and the distance between the drape plate and the trocar. Experimental results show that error is induced by the asymmetric shape of the trocar tip because contact position between the instrument and the trocar tip is changed depending on the direction of the interaction force. The theoretical relation, therefore, is compensated and reduced. Average $L_2$ relative error of the estimated force in the x-direction and the y-direction is 5.81 % and 5.99 %, respectively.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.87-92
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• 1989

Transbuccal trocar has been an established method of fixation for the bone plate in the case of mandibular angle fracture. Other than extraoral approaches, this transbuccal approach has many advantages in the treatment of the fracture of mandibular angle. These advantages are as follows ; (1) Damage to the facial nerve branches is minimal. (2) Less postoperative scar is formed. (3) Good vision of occlusion can be easily obtained on the entire operation. (4) Shorter operation time is needed. But, in the clinical procedure of plate fixation, it is has a difficulty in manipulation of the plate and correction of position. To solve these problems, we designed and used a trocar tip which can be easily attached to the trocar, and could make an improvement in the clinical procedures.

• Journal of Gastric Cancer
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• v.12 no.1
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• pp.46-48
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• 2012

A trocar site hernia is a rare complication. We report a patient who had an abdominal wall mass at a previous trocar site after laparoscopic distal gastrectomy. It was diagnosed as omental herniation and fat necrosis. We conclude that patients with trocar site masses exhibiting fat density on a computed tomography scan could be followed up without surgery, and that fascial defects located at 10-mm or larger trocar sites should be closed whenever possible to prevent hernia formation.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.80-84
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• 2016

Background: Video-assisted thoracoscopic surgery (VATS) pulmonary wedge resection has emerged as the standard treatment for primary spontaneous pneumothorax. Recently, single-port VATS has been introduced and is now widely performed. This study aimed to evaluate the outcomes of the Tower crane technique as novel technique using a 15-mm trocar and anchoring suture in primary spontaneous pneumothorax. Methods: Patients who underwent single-port VATS wedge resection in Chungnam National University Hospital from April 2012 to March 2014 were enrolled. The medical records of the enrolled patients were reviewed retrospectively. Results: A total of 1,251 patients were diagnosed with pneumothorax during this period, 270 of whom underwent VATS wedge resection. Fifty-two of those operations were single-port VATS wedge resections for primary spontaneous pneumothorax performed by a single surgeon. The median age of the patients was $19.3{\pm}11.5$ years old, and 43 of the patients were male. The median duration of chest tube drainage following the operation was $2.3{\pm}1.3days$, and mean post-operative hospital stay was $3.2{\pm}1.3days$. Prolonged air leakage for more than three days following the operation was observed in one patient. The mean duration of follow-up was $18.7{\pm}6.1months$, with a recurrence rate of 3.8%. Conclusion: The tower crane technique with a 15-mm trocar may be a promising treatment modality for patients presenting with primary spontaneous pneumothorax.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.399-403
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• 2010

Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.296-299
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• 2006

Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport [Auto Suture Co., Norwalk, CT] by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes [diameter and length], and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.

• Journal of Veterinary Clinics
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• v.9 no.1
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• pp.311-316
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• 1992

Four retention sutures were used to correct the vaginal prolapse in a dairy cow. The methods used were two modified Caslick operation of vulva using absorbable(catgut chromic) and nonabsorbable(supramid) materials, and a modified mattress closure and a modified Buhner method of vulva using trocar and wire insulated by vinyl. The lasting periods for retention of bovine vaginal prolapse by the suture methods described above, were 12 days, 49 days, 39 days and 62 days respectively.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.418-422
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• 2011

Background: It has recently become most general to use the small bore catheter to perform closed thoracostomy in treating iatrogenic pneumothorax. This study was performed for analysis of the efficacy of treatment methods by using small bore catheter such as 7 F (French) central venous catheter, 10 F trocar catheter, 12 F pigtail catheter and for analysis of the appropriateness of each procedure. Materials and Methods: From March 2007 to February 2010, Retrospective review of 105 patients with iatrogenic pneumothorax, who underwent closed thoracostomy by using small bore catheter, was performed. We analyzed the total success rate for all procedures as well as the individual success rate for each procedure, and analyzed the cause of failure, additional treatment method for failure, influential factors of treatment outcome, and complications. Results: The most common causes of iatrogenic pneumothorax were presented as percutaneous needle aspiration(PCNA) in 48 cases (45.7%), and central venous catheterization in 26 cases (24.8%). The mean interval to thoracostomy after the procedure was measured as 5.2 hours (1~34 hours). Total success rate of thoracostomy was 78.1%. The success rate was not significantly difference by tube type, with 7 F central venous catheter as 80%, 10 F trocar catheter as 81.6%, and 12 F pigtail catheter as 71%. Twenty one out of 23 patients that had failed with small bore catheter treatment added large bore conventional thoracostomy, and another 2 patients received surgery. The causes for treatment failure were presented as continuous air leakage in 12 cases (52.2%) and tube malfunction in 7 cases (30%). The causes for failure did not present significant differences by tube type. Statistically significant factors affecting treatment performance were not discovered. Conclusion: Closed thoracostomy with small bore catheter proved to be effective for iatrogenic pneumothorax. The success rate was not difference for each type. However, it is important to select the appropriate catheter by considering the patient status, pneumothorax aspect, and medical personnel in the cardiothoracic surgery department of the relevant hospital.

• Safety and Health at Work
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• v.14 no.2
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• pp.237-242
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• 2023

Background: This study evaluated occupational exposure levels of doxorubicin in healthcare workers performing rotational intraperitoneal pressurized aerosol chemotherapy (PIPAC) procedures. Methods: All samples were collected during PIPAC procedures applying doxorubicin to an experimental animal model (pigs). All procedures were applied to seven pigs, each for approximately 44 min. Surface samples (n = 51) were obtained from substances contaminating the PIPAC devices, surrounding objects, and protective equipment. Airborne samples were also collected around the operating table (n = 39). All samples were analyzed using ultra-high performance liquid chromatography-mass spectrometry. Results: Among the surface samples, doxorubicin was detected in only five samples (9.8%) that were directly exposed to antineoplastic drug aerosols in the abdominal cavity originating from PIPAC devices. The telescopes showed concentrations of 0.48-5.44 ng/cm² and the trocar showed 0.98 ng/cm² in the region where the spraying nozzles were inserted. The syringe line connector showed a maximum concentration of 181.07 ng/cm², following a leakage. Contamination was not detected on the surgeons' gloves or shoes. Objects surrounding the operating table, including tables, operating lights, entrance doors, and trocar holders, were found to be uncontaminated. All air samples collected at locations where healthcare workers performed procedures were found to be uncontaminated. Conclusions: Most air and surface samples were uncontaminated or showed very low doxorubicin concentrations during PIPAC procedures. However, there remains a potential for leakage, in which case dermal exposure may occur. Safety protocols related to leakage accidents, selection of appropriate protective equipment, and the use of disposable devices are necessary to prevent occupational exposure.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.43-48
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• 2010

Gastric trichobezoars are commonly observed in young women with trichotillomania and trichophagia. We encountered an 8-year-old girl who had trichotillomania and trichophagia with abdominal pain and a mass, which was diagnosed as a large gastric trichobezoar. On physical examination, a huge, firm nontender mobile mass was palpated in her epigastrium. An upper gastrointestinal series and abdominal computed tomography (CT) scan showed a large mass in the stomach. Endoscopic removal was tried but failed. Laparoscopic removal was therefore performed. The trichobezoar was successfully retrieved through a gastrotomy and removed through an extended umbilical trocar incision. This case demonstrates that laparoscopic removal of large gastric trichobezoars is feasible and safe without a large abdominal incision.